Holistic Approach to Enhance Airborne Infection Control Practices in Health Care Facilities Involved in the Management of Tuberculosis in a Metropolitan City in India - An Implementation Research.

Abstract

Background: Airborne infection control (AIC) is a less focused aspect of tuberculosis (TB) prevention. We describe AIC practices in primary health care centres, awareness and practices of AIC among health care providers (HCPs) and TB patients. We implemented a package of interventions to improve awareness and practices among them and assessed its impact.

Methodology: The study used a quasi-experimental study design. A semi-structured checklist was used for health facility assessment and a self-administered questionnaire of HCPs. Pre- and postintervention assessments were made in urban primary health centers (UPHCs), HCPs, and patients. Interventions included sharing facility-specific recommendations, AIC plans and guidelines, HCP training, and patient education. Statistical difference between the two time periods was assessed using the Chi-square test.

Results: A total of 23 and 25 UPHCs were included for pre- and postintervention assessments. All 25 centers participated in interventions. Open areas were >20% of ground area in all facilities. No AIC committee was present in any of the facilities at both pre- and postintervention. Of all HCPs, 7% (23/337) versus 65% (202/310) had undergone AIC training. Good awareness improved from 24% (81/337) to 71% (220/310) after intervention (P < 0.001). Appropriate cough hygiene was known to 20% (51/262) versus 58% (152/263) patients at two assessments (P < 0.001).

Conclusion: Comprehensive intervention, including supportive supervision of health centers, training of HCPs, and patient education, can improve AIC practices.